Degrees of hypertension and risks

Hypertension is the most common cardiovascular disease, the symptoms of which after the age of 60-65 affect a large part of the population. The diagnosis has several names, including essential hypertension (AH), arterial hypertension (AH). The disease is chronic, the main task of each patient is to avoid exacerbations and prolong the period of remission (disappearance of symptoms) using medication and non-drug methods.

What is hypertension

Arterial hypertension is a steady increase in blood pressure above an acceptable level (starting from 140/90 mm Hg) under the influence of provoking factors. This diagnosis is called the "silent killer". The pathological process proceeds in an asymptomatic form for a long time, but during an attack it significantly increases the risk of stroke, myocardial infarction, and other dangerous diseases. Potential complications of GB can threaten the life of the patient, so the disease needs timely diagnosis and adequate treatment.

Hypertensive disease develops as a result of dysfunction of the higher centers of neurohumoral regulation, kidneys, blood vessels. In the absence of timely treatment, the pathological process leads to organic and functional disorders of the heart, organs of the central nervous system, and kidneys. Incorrectly selected therapy can lead to the progression of the disease with increased pain.

Classification of hypertension

In 2003, a unified classification of hypertension was defined according to the severity of the disease. The determining factor in this division is considered to be the real blood pressure indicator, determined by the tonometer in a particular clinical case. Hypertension is also classified by origin (primary, secondary), stages (transient, stable, sclerotic) and the level of risk of cardiovascular pathologies. This classification simplifies the diagnosis, helps to more accurately determine the treatment regimen for each hypertensive patient.

Degrees of arterial hypertension

With an increase in blood pressure (BP), there is a suspicion that arterial hypertension is progressing, especially if it is not possible to solve this health problem with non-drug methods. It is important to know that the optimal blood pressure is 120/80 mm Hg. Art. , normal - 120-129 mm Hg. Art. (systolic pressure - SBP) and 80-84 mm Hg. Art. (diastolic - DBP), high normal - 130-139 mm. rt. Art. (SAD) and 85-89 mm. rt. Art. (DAD). Deviation from these figures indicates serious pathologies of the body. Doctors distinguish 3 degrees of GB:

1. Hypertensive disease of the 1st degree (mild) is characterized by unstable pressure, which for several days ranges from 140/90 to 159/99 mm Hg. Art. The risk of developing a hypertensive crisis is minimal, there are no symptoms of organic damage to internal organs and the central nervous system. To suppress a painful attack, in addition to taking medication, the patient needs a good rest, the exclusion of stressful situations. Positive emotions, walks in the fresh air are especially useful.
2. Arterial hypertension of the 2nd degree develops rapidly. The blood pressure index varies from 160/100 to 179/109 mm Hg. Art. , there are symptoms of a hypertensive crisis (cold sweat, goosebumps, redness of the face). The patient is concerned about migraine attacks, dizziness, poor sleep, shortness of breath. Clinical manifestations of hypertension: transient cerebral ischemia (decrease in blood flow in the organ), rise in creatinine in the blood, narrowing of the retinal arteries, hypertrophy (increase in size) of the left ventricle, microalbuminuria (detection of protein in urine analysis). It is not possible to normalize the condition without medication.
3. Hypertensive disease of the 3rd degree (severe) is accompanied by a sharp decline in visual acuity, poor memory, tachycardia attacks (increased heart rate). A hypertensive crisis develops. BP indicator - from 180/110 mm Hg. Art. and higher. Possible complications include hypertensive encephalopathy, cerebral vascular thrombosis and aneurysm (pathological expansion of the vessel), left ventricular heart and kidney failure, hemorrhages (bruising) and swelling of the optic nerve. Pathological changes are irreversible.

Degree of cardiovascular risk

To predict the likelihood of complications in progressive arterial hypertension, the first step is to determine the index of cardiovascular risk. This requires specialist advice, complex diagnostics. The degree of hypertension, provoking relapse circumstances (physiological and pathological) are taken into account. Common risk factors are:

• smoking, other bad habits;
• high cholesterol in the blood;
• sedentary lifestyle;
• obesity, including abdominal (most of the fat is deposited in the abdomen);
• age (women over 65, men over 55);
• fasting sugar index 5. 6-7. 0 mmol/l;
• impaired glucose tolerance, determined using a special test;
• the presence of diseases of the cardiovascular system in relatives;
• male.

The patient has a high degree of cardiovascular risk if, in addition to hypertension, there are concomitant chronic diseases:

• diabetes;
• heart failure;
• violation of lipid (fat) metabolism;
• bronchial asthma;
• extensive damage to the retina;
• coronary artery disease;
• renal failure stage 4;
• suffered a stroke;
• cerebrovascular diseases (damage to the vessels of the brain);
• signs of obliterating diseases of the peripheral arteries of the lower extremities (atherosclerosis);
• damage to other internal organs.

Such information helps the doctor to predict the clinical outcome of the disease. To determine the indicator of cardiovascular risk for each degree of hypertension, you need to familiarize yourself with the table below:

General Risk Factors (RFR)	Blood pressure	Hypertension 1 degree risk	Arterial hypertension of the 2nd degree, risk	Hypertension grade 3 risk
no risk factors	ordinary risk	short	moderate	tall
1-2	short	moderate	moderately high	tall
over 3	low-moderate	moderately high	tall	tall
damage to other internal organs, kidney disease stage 3, diabetes mellitus	moderately high	tall	tall	very tall
cardiovascular disease, stage 4 chronic kidney disease with other organ involvement or common risk factors	very tall	very tall	very tall	very tall

Treatment of hypertension

The classification of GB according to stages and risks helps to correctly determine the drug therapy regimen, quickly stop a painful attack, and prolong the period of remission. If primary arterial hypertension develops (isolated), subject to medical recommendations, the prognosis is favorable. The secondary form of the disease often occurs with complications.

If the disease is not cured in time, it is difficult to stabilize high blood pressure even with medication. General recommendations of specialists, if grade 1, 2 or 3 hypertension is diagnosed, are presented below. . Should be supplemented by taking medications as prescribed by the attending physician:

1. Compliance with a therapeutic diet. It is important to reduce portions of table salt, enrich the daily diet with foods with potassium and magnesium to strengthen the heart muscle (seeds, nuts, legumes and cereals, greens).
2. Rejection of bad habits. This applies not only to drinking and smoking, but also to the need to increase physical activity, leave behind a "sedentary" lifestyle, and take walks in the fresh air.
3. Weight control. If a patient with arterial hypertension has obesity, it is necessary to abandon fatty, fried and smoked foods, and regularly arrange fasting days.
4. Physiotherapy. In order to prevent and prolong the period of remission of GB, it is recommended to perform moderate-intensity physical exercises for 30 minutes 5 times a week.
5. Reception of multivitamin complexes. The composition of such medicines should contain potassium, magnesium, iron, and other trace elements important for the body.

Medical therapy

Oral medication depends on the degree of hypertension and associated symptoms. Below are the optimal schemes for the conservative treatment of arterial hypertension:

1. In the mild stage of the disease, the patient is prescribed angiotensin-converting enzyme inhibitors, angiotensin receptor antagonists, calcium channel blockers.
2. If arterial hypertension of the 2nd degree risk 4 develops, an integrated approach to the problem is needed, which combines several representatives of different pharmacological groups in one conservative treatment regimen. These are the above medicines in combination with thiazide diuretics.
3. In the complicated course of this disease, in addition to the above medications, doctors recommend alpha- or beta-blockers. The need for this arises if high doses of diuretics are poorly tolerated by a weakened body).